J RANDY GIPPLE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

First Name

J RANDY

Last Name

GIPPLE

Business Name

J RANDY GIPPLE

Original Issue Date

06/15/1994

Effective Date

06/15/1994

Expiration Date

07/31/1996

City

GENESEO

State

Zip

61254

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006